KRYSTAL ANNIE BODILY (NPI# 1912463407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912463407 |
| Entity Type | Individual |
| Full Name | KRYSTAL ANNIE BODILY |
| Credential | FNP |
| Practice Address |
751 Lombardi Ct Santa Rosa CA 95407-6798 |
| Mailing Address |
2657 Bailey Ct Fremont CA 94536-5304 |
| Practice Telephone | 7075472222 |
| Mailing Telephone | 5103625264 |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 95011099 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS | 95011099 | 01 |
| Street Address |
751 LOMBARDI CT |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-6798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831163716 | Tara Jeanine Budinger | Psychologist | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2006-02-15 |
| 1982214870 | Roxanne Patricia Schleben | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2020-08-05 |
| 1952932709 | Benjamin Robert Zumwalt | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2020-01-30 |
| 1114569878 | Daisy Ariana Lopez | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2019-10-15 |
| 1205309580 | Daniel Christopher Lopez | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2019-01-09 |
| 1508334327 | Sharon Sneddon | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-11-09 |
| 1801382494 | Michael Bastien Nowak | Registered Nurse | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-07-06 |
| 1417458654 | Eleanna Alexia Kennedy | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-02-22 |
| 1336657204 | Lluriana Bailon | Registered Nurse | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-01-13 |
| 1316479850 | Arunima Kohli | Family Medicine | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2017-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346889581 | Herbert Carey Pratt | Family Medicine | 4210 Thomas Lake Harris Dr Apt 217, Santa Rosa, CA 95403-5793 | 2020-01-06 |
| 1346883998 | Teresa Su | Family Medicine | 2200 County Center Dr Ste C, Santa Rosa, CA 95403-3000 | 2019-10-25 |
| 1114468568 | Erica Kumala | Family Medicine | 401 Bicentennial Way Ste 285, Santa Rosa, CA 95403-2149 | 2017-03-18 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1467745950 | Courtney King | Family Medicine | 4702 Starbuck Ave, Santa Rosa, CA 95409 | 2011-05-17 |
| 1801186648 | Adam Crawford Francis | Family Medicine | 3569 Round Barn Cir Ste 200, Santa Rosa, CA 95403-1757 | 2011-04-13 |
| 1811217003 | Dora Alicia Martinez | Family Medicine | 122 Fm 506, Santa Rosa, TX 78593-0226 | 2010-06-10 |
| 1558518290 | John Andrew Carollo Jr. | Family Medicine | 5555 Montgomery Dr Apt 36, Santa Rosa, CA 95409-5597 | 2008-08-25 |
| 1154577831 | Sutter Medical Group of The Redwoods | Family Medicine | 500 Doyle Park D., 200, Santa Rosa, CA 95405 | 2008-08-13 |
| 1013175918 | Lucia Dei Roncalli | Family Medicine | 1010 Sundown Trl, Santa Rosa, CA 95404-1115 | 2008-05-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
Please comment or provide details below to improve the information on KRYSTAL ANNIE BODILY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.